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Answer to Puzzler #45

You can try your hand at Past Puzzlers, too!

The Scenario:

The snow fell heavily, blanketing the fields. Beautiful to watch from indoors; it was another thing to shovel the driveway.

Fred has a monster snow blower that he looks forward to using on such occasions. But today was not his lucky day. After working on the machine for half an hour, he was unable to get it started. He mulled over his forgetfulness at not draining the gas tank last spring.

Reverting to an old-fashioned but reliable technique, he grabbed his shovel and went to work. Twenty minutes into it he began to notice a slight pressure in his chest. Thinking he was probably pushing himself too hard, he stopped, rested and stretched for a few moments. The pressure went away and he went back to work. Within minutes the pressure returned, this time much worse. He felt a tight constriction in his chest and found it hard to breathe. Then he began to feel lightheaded and sick to his stomach.

Question: What is happening to Fred, and what should he do at this point?

Answer:

Most people recognized that Fred was having a heart attack, as his symptoms are fairly classic. Fred undoubtedly has coronary heart disease with at least one, and probably multiple sites of narrowing of his coronary arteries. What generally happens at the time of a heart attack is that a blood clot suddenly forms at the site of one of these narrowings, causing complete blockage of the circulation. Chest pain is caused by the sudden absence of oxygen being delivered to his heart muscle. Unless this blockage is rapidly opened using clot dissolving medications, or a procedure known as balloon angioplasty, death of heart muscle tissue will ensue, with many potential complications for Fred.

He must get to an emergency room as fast as possible. The fewer minutes or hours that pass before treatment is begun the better. An ambulance is the best way to go, as he could suffer a sudden cardiac arrest at this point -- this is not something you want to happen with him sitting in the car, nor should he be driving.